How to have a tough conversation with the practice owner

Do you need to have a difficult conversation with your boss?

As the Practice Manager, you are responsible for the day to day running of the Practice, looking after the operational, financial, sales & marketing, customer service and staffing needs of the business.

Possibly the biggest challenge you may face, is when you have to deal with a difficult situation involving your Practice Owner or Principal Doctor.
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This could arise due to working relationships or business operations.

Here are some situations that I’ve seen Practice Managers come across:

• You feel micromanaged and aren’t empowered to manage the Practice without interference.
• You feel that they undermine your authority by bypassing you and going directly to your staff.
• They direct you to discipline a staff member, but you disagree that this is the right approach.
• You have different opinions on staff payment or scheduling of staff.
• You have received complaints from staff about how they are treated by the owner or senior doctor.
• You have received a patient complaint about them.
• You have had a disagreement over how to manage or run the Practice.

​It’s okay to tell your boss that you are unhappy with certain issues, as long as it’s done in the right way.

In fact, you should speak up sooner rather than later before the situation escalates and has a negative impact on your working relationship, staff morale, or the business.

Honest feedback helps bosses and leaders understand how others perceive them. Constructive feedback is useful for everyone in the workplace and providing it to your boss can help him or her see where they may have areas for improvement that they are not aware of. It’s not uncommon for people to be unaware of the impact they may be having on others until someone tells them. After all your boss is only human, just like all of us!

Overcoming your fears is important if the concerns are genuine and are negatively impacting the Practice or your working relationship. If your boss is undermining your ability to do your best work, you should let him or her know. Don't let it escalate into a bigger issue that damages your working relationship.
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Here are some practical strategies that will help you conquer your fears and speak up.
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1. Take an honest look at the problem
2. Prepare
3. Think of solutions
4. Timing is everything
5. Be professional
6. Ask questions and listen with an open mind
7. The meeting
8. Seek advice

Take an honest look at the problem

Remove the emotion from the situation and look at the matter objectively.

Answering these questions honestly will help you gain perspective on the situation:

• What is the main issue?
• What is the person doing to contribute to, or cause the problem?
• Are you, or someone else, also contributing to the difficult situation?
• What are some specific examples?
• What impact is this having on the Practice, staff, or patients?
• How important is it that you deal with the problem?
• What are the consequences of not dealing with the problem?
• Is your reaction proportionate to the problem?
• Do you have a good/difficult working relationship with this person? Has your working relationship changed?
• Will this person be open to feedback? Are they likely to change their behaviour?
• Is there anything you need to change or do differently to contribute to resolving the situation?
• Are you, or other people who are involved, being overly critical or emotional about the situation?

Analyse your role in the problem. Conflicts between you and your boss may be caused by one or both parties. Ask yourself what you can do to improve a situation. Identifying behaviours that you can change to improve the relationship is empowering. Avoid judgment, step back and take an objective look at the relationship between you and your boss.
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Once you have clarity on the problem and you believe that you should pursue it, then move onto the next steps.

Prepare

Before having the difficult conversation, prepare what you want to talk about.

Gather facts and specific examples.

Try to stay away from personal opinion.
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Think about how you will explain the problem and the impact that it is having on you, others, or the Practice.

Think of solutions

Think of a solution before bringing concerns to the attention of the owner even if you think they are the problem. Employees who bring up problems without offering suggestions risk being viewed as complainers. Have at least one possible solution that you can offer. Focusing on solutions puts a positive spin on the discussion. When approached in this manner, a boss is more likely to listen and agree to the proposed resolution.
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You were hired to manage the practice and make the owner’s life easier – this is an opportunity for you to demonstrate your leadership skills by offering solutions rather than just identifying problems.

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Timing is everything

Pick the right time to have the conversation.

Choose the best time, place and communication method that makes them comfortable and sets you up for success.

Organise a one-on-one meeting with them, do not confront them in front of others. Ideally, you should schedule this meeting during a relatively quiet time, if possible, when the owner isn’t dealing with some kind of crisis, is under pressure or in a rush.

If you schedule this meeting by asking them in person, you need to be ready have the conversation on the spot, as they may want to know what the issue is there and then. So be prepared.
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Bringing up a problem before it escalates helps with resolving issues in the workplace. Putting it off will only frustrate you and complicate possible solutions.

Be professional

Don't bad mouth or gossip about them. It won't help the situation. If you need to speak to someone within your network or work environment because your work is being impeded or negatively impacted by the situation with your boss, do so professionally and discreetly.

Using a positive tone and speaking in a calm manner is essential when talking to your boss. Be respectful and acknowledge ways that he or she is otherwise helpful and supportive. Relate the issue to your shared goals and a desire to see the Practice thrive.

It's essential to stay professional and to concentrate on the business, even if their behaviour has impacted you personally. Focus on how the issue impacts the Practice and your team’s goals.

Be polite and tactful. Use a less emotive and a more collaborative approach and lead the owner into problem-solving mode rather than an argument. 

If your boss's actions are especially serious, or legislative compliance is compromised, it's important that you put your concerns in writing to cover yourself. 

Delivering the message may be tricky. It's important to deliver criticism in a way that will be heard, understood, and appreciated.

Be concise and to the point.

Keep feedback focused, clear and unemotional.

Show empathy - perhaps you know they are very busy, under pressure etc., so acknowledge this.

Avoid making it personal.

Uses phrases such as:

• Our team is experiencing……
• I understand where you are coming from……
• Here’s how we could work together more effectively……

Ask questions and listen with an open mind

Bosses often have a broader context of the business than employees. Before you point out problems, make sure you have as much information as possible.

Seek to understand the situation and the context.

Having a conversation and asking good questions may help both parties understand the situation, see things from each other’s perspective and get a sense of how their behaviour or actions impacts others.
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Be willing to change your perspective if offered with information you were not aware of which changes the situation or context.

The meeting

Following this structure during the meeting will help keep the conversation focused:

• State the problem
• Listen to their response
• Ask questions
• Reassess your position, if applicable
• Agree on a solution

Seek advice

​Having a tough conversation with your Practice Owner is not easy. Seek advice from a trusted friend, colleague or HR Advisor if needed.

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